Every doctor who treats cancer patients can tell you stories of patients who present with cancers too advanced to treat because they were spending their time pursuing alternative treatments. This has also been studied - last year a Yale team published a study showing higher rates of death among cancer patients who choose alternative treatments.
There is now a recent story of a YouTuber who produced videos claiming that a vegan diet and prayer cured her stage 4 cancer, except now she has died from her cancer. Of course, I am sad for her death and that the treatments she sought at the end were not enough to save her. It's likely that everyone knows someone affected by cancer - it is a scary and often tragic disease. At the same time, we can't miss the lessons in this story. It is so typical it can serve as an archetype.
What typically happens is that when some people are diagnosed with cancer they search for any possible salvation from their situation. That is understandable. Often there is an initial treatment, such as removal of a solid tumor, or shrinking the tumor with drugs. Some patients may also seek additional intervention, such as alternative treatments or faith healing. At that point they are in the honeymoon phase of the illness - no matter what their ultimate prognosis, their symptoms were likely improved by the initial treatment. They can imagine that they are cured. This is usually the point at which they claim that whatever alternative or faith-based treatment they underwent healed them.
Depending on the type of cancer, some of these patients may have been essentially cured by their initial surgery or treatment. For those who weren't, a recurrence of symptoms is inevitable. We then may or may not hear about them when the cancer returns and leads to their death.
What this means is that newly diagnosed cancer patients can find countless stories of people claiming to have been "cured" of their cancer by all sorts of nonsense. There will always be a cohort of people in the honeymoon phase of their illness. This is the pitfall of anecdotal evidence. It is selective and biased.
What we really want is a systematic assessment of what the result of various treatment choices are. If you have a specific kind of cancer, and you choose the recommended treatment regimen what will be your outcome, statistically? What are your chances if you delay or refuse treatment, or if you rely on various alternative treatments? Well, we have this data - if you rely on alternative treatments your chance of death is increased.
The story of Mari Lopez, linked to above, follows this typical pattern. She became a popular YouTuber with her niece, Liz. Together they claimed that juicing, a vegan diet, and prayer cured Mari's stage 4 cancer. When Mari's cancer returned, she understandably became depressed. She asked Liz to take down the videos claiming she was cured, but Liz refused. She has doubled-down on her claims in the face of such dramatic evidence to the contrary.
How is this possible? The power of a strong narrative. Just read the comments below the article and you will see a typical battle of world views. The evidence is mostly irrelevant, because you can simply filter the evidence and choose whatever your reality is.
If find it instructive that Mari and Liz mixed together the claims that diet and faith cured Mari. Both, in fact, are manifestations of faith. Alternative medicine is often a mixture of pseudoscience and faith healing, blended seamlessly together.
The faith claims have a significant problem with logic and consistency. I don't begrudge anyone their personal faith, but I do think it is counterproductive to depend for anything important on a mythical being you just hope exists. What I always find intriguing is those who claim that God cured them of a disease, but not really. In this case Liz believes that God cured Mari of her cancer, but Mari wavered, so the cancer came back and killed her. Really?
First, that is a pretty incompetent cure. I would expect more from an omnipotent being. The other implication, if you are going to give God credit for the cure, then he has to get the blame for the return. That means that God smote her, struck her down with cancer because she had a hamburger. You can draw your own conclusions about what kind of god would do that.
Liz's current rationalization for Mari's death, which seems to contradict her entire YouTube career, is that toward the end Mari was cheating on her vegan diet. You see, the juicing was only just keeping the cancer at bay (which is why they claimed she was completely cured). The moment she started to waver in her vegan purity, and gave in to the temptations of beef, the cancer claimed her.
This is another absolutely typical part of the faith healing narrative, borrowed heavily by the alternative medicine narrative. Failures are always blamed on the patient. It is a convenient rationalization - they lacked sufficient faith in the case of the former, and they did not adhere fanatically enough to the regimen, for the latter.
That is often the extra layer of cruelty imposed by alternative cancer cures. First, target someone who is extremely vulnerable because they were just given a scary diagnosis and face months or years of horrible treatment. Lure them away from logic and evidence with the promise of salvation. Turn them against the doctors who are trying to give them objective evidence-based advice. Convince them that their doctors are just money-grubbing shills for an evil industry of death.
Now that you have them in your clutches, suck every ounce of money out of them you can. You can maximize your profits if your victim is willing to raise money from family and friends. Cancer patients are very sympathetic and good as props for fundraising.
While they are busy raising money to pay you, make sure whatever time they have left will be spent pursuing a draconian treatment regimen - consuming massive amounts of raw vegetables, and getting coffee enemas, for example. This may seem unnecessarily cruel, but this is important. When their cancer returns you can then blame them for not following the impossible regimen strictly enough. This is the best way to deflect any blame for the bad outcome. They will be too busy feeling guilty as well as depressed.
This may seem like a dramatic story, but it is literally true in many cases. Not all alternative treatments are this cynically bad or extreme, but this is not uncommon, and most will incorporate some of these features.
Yes, mainstream treatment is expensive and harsh too. Cancer is a serious disease and often requires aggressive, even desperate, treatment. The difference is, mainstream treatments are based on a thoughtful analysis of the best evidence available, and patients are given detailed informed consent. Alternative treatments are a package of lies, pseudoscience, false hope, and deception. But they are wrapped in a compelling narrative (if it fits your world view).
So Liz thinks that Mari was killed by her backsliding on her juicing and vegan diet, and that God reneged on his miraculous cure. That is apparently easier than questioning her alternative medicine narrative. I can understand that - because that would involve facing the fact that delaying conventional treatment while putting her faith in juicing may have contributed to, and even lead to, Mari's death.
It is important to point all this out, not for Mari (her story is over) and not for Liz (who is probably a lost cause) but for all those other recently diagnosed cancer patients out there. Facing a cancer diagnosis requires a bit of courage, and a lot of support. False hope and deceptive but alluring narratives literally kill. Many cancer patients will also tell you that after their diagnosis well-meaning friends, family, coworkers, and other acquaintances come out of the woodwork to offer their completely unsolicited medical advice.
Here is my advice - don't do this. Just stop. You are not a doctor, not an expert, and your Google university degree does not mean you can practice medicine. The person you are trying to help either will be harmed by you, if they follow your advice, or at best will be extremely annoyed. You are just adding emotional pain to their situation. They don't want the guilt and pressure of being told that they need faith, or they need to keep a positive attitude, or they need to start juicing and avoid meat.
Stop it. You don't know what you are talking about. You are just causing pain and harm, despite your intention. Just give them love and support, and let medical professionals take care of the rest.

A couple months ago I received my first virtual reality (VR) headset, and have been experimenting with various games and apps since. (Here is my initial review.) As a neuroscientist, it is a fascinating demonstration of how our brains construct our experience of reality.
What I and everyone who has used my gear has experienced is surprise at how visceral VR can be. It's just a big video, right, so why do our lizard brains react so strongly? The most dramatic example is an app called "The Plank Experience". In it you take an elevator up to a high floor in a skyscraper. The door opens to reveal a plank going out over the street far below. Everyone so far is frozen at the moment the doors open and they see the chasm below them. Some can walk out onto the virtual plank, but most people hesitate and at least one person bailed and would not do it.
What is interesting is that when I stepped out onto the plank, I completely 100% knew that I was standing on the carpet in my office, totally safe and at no peril at all. However, the part of my brain that knew I was safe was in conflict with a deeper and more primitive part of my brain that was screaming, "Danger, danger." It took an effort of will to overcome the fear, but I could not make the fear go away.
Let me describe one other part of the VR experience and then I'll discuss what is going on neurologically. Motion sickness has been a major challenge for VR. All of the games and apps I have used so far have an option (usually the default) where if you have to move your character in the VR world you do it by teleporting. You use the control to place an X on the floor where you want to go, and then you are instantly in that location. This type of movement does not produce any motion sickness.
However, in some games it is possible to "run" through the world. With any kind of continuous movement of my avatar, even a little, I am instantly motion sick. I essentially cannot tolerate this kind of movement. People apparently differ in this regard, but mostly as a matter of degree. VR developers have not been able to make the problem go away through technical fixes, such as resolution or visual tricks. They essentially just had to provide other ways of moving in the VR world. (Companies are still working on other options, but nothing is out yet.)
Both of these aspects of VR stem from the same neurological phenomena. You can understand them if you understand that your experience of yourself and the world are completely constructed by your brain. You don't directly experience your sensory input. Rather, that input is filtered, altered, analyzed, compared, and then finally constructed into a seamless experience.
For many sensory constructions there is a threshold effect - your brain essentially makes choices of how to construct sensory streams, and once those choices are made, the construction snaps into place. It is often an all-or-none phenomenon.
This is most apparent with common optical illusions. One class of optical illusion derived from ambiguous stimuli. Are you looking at a rabbit or an old woman? Is the girl spinning to the left or right? Is the box pointing up or down? Your brain will construct the image one way or the other, but not both, depending on assumptions about what is foreground, what is background, orientation, and shading.
Other illusions are pictures that are right at the threshold of our brain's ability to construct the apparent image. Snow and rocks can instantly turn into a picture of a dalmation, and once you see it, you cannot unsee it. The construction is in place.
Even more interesting is that part of this construction of your perception of reality that your brain does includes a perception that you exist, that you occupy, own, and control your various body parts, and that you are separate from the rest of the universe. These components of your experience are actively constructed, and can be disrupted.
Part of these constructions involve another phenomenon mentioned above - your brain compares the various sensory streams. It also compares them to other processes in the brain, such as your intention to move. For example, your vision indicates your relationship to your surroundings and whether or not you are moving. Vestibular sensation senses movement and orientation to gravity. These two sensory streams should be telling the same story - your brain expects to see and feel the same movement at the same time. When these two sensory streams do not match, you feel motion sick.
That is what is happening dramatically with VR. You see yourself running through the virtual landscape, but your vestibular system feels you are standing still. Teleporting gets around this because you don't see yourself move, you are just instantly in the new location. Your brain processes smooth movement different than sudden jumps. It's possible this is due to the fact that we don't teleport in the real world, and so our brains would not be adapted to experience it. But also, our eyes have both smooth pursuit and sudden "saccadic" movements. Our eyes can jump from one target to the next, and when we do this we don't become disoriented. Our brains suppress the sudden change. Perhaps our brains treat teleporting in VR like saccadic eye movements.
Turning back to the visceral experience of VR, this is likely also similar to an optical illusion. Just like you cannot unsee your brain's construction of ambiguous stimuli, you cannot convince the subconscious part of your brain that you are not standing on a plank 40 floors above the street.
The visual system does not only construct what it thinks it is seeing, but then it also connects the resulting construction to other parts of the brain that trigger memory and also emotion. The visual stream connects directly to the limbic system, assigning emotional significance to what you see. You feel love, hunger, anger, or fear automatically based on the visual stimuli.
Further, the more sensory streams that are involved in an experience, the stronger the construction. VR systems, obviously, include sound also. So you hear the wind whistling by your ear, and that contributes to the illusion you are in danger of falling to your death. Blow a small fan in the face of someone walking the virtual plank, and the illusion becomes more powerful still.
I experienced this type of illusion in some of the newer them park rids. The Spiderman ride in Universal is essentially virtual reality, but instead of wearing goggles they use large screens built seemlessly into the environment. They use small movements of the car you are sitting in to simulate the car falling off a building and careening through the city. At one point you are faced with a villain with a large blow torch, and you are met with a blast of warm air which totally sells the illusion.
To illustrate the power of multi-sensory illusions (and the fundamental nature of our brain's reality construction) there are experiments in which people sit at a table. One arm is on top of the table, while the other is below and covered by a sheet. There is a fake arm on top of the table where the real arm is hidden. All it takes is for someone to touch the fake arm while also touching your real but visually hidden arm - you see and feel the fake arm being touched. The alignment of these two sensory stimuli is enough to convince your brain much of the time that the fake arm is actually part of your body.
Our brains also compare our intention to move with sensory feedback (visual and proprioception) that indicates we actually have moved, and this creates the sensation that we control our body parts. The construction is also easily broken if these two streams do not match, or one is disrupted. This results in what is called "alien hand syndrome" - the sensation that your body part is not under your control.
What all this also means is that we can easily trick the brain into constructing reality so that you occupy and control a virtual avatar, and that you are living in the VR world. It will be real to you - just as real as the plank.
The visual part of VR is now above the waterline - it is good enough to convince your brain that it is real. Incremental advances will be nice, but the technology has arrived. What VR developers are working on now are the other senses. Haptic feedback means giving sensory feedback to match what the person sees. So if you touch a virtual object, the haptic glove you are wearing gives the sensation of touch to match. Others are working on ways to fool the vestibular system to sense the movement you are seeing. This would fix the motion sickness problem, but it remains to be seen if they will succeed. One company, for example, is working on a system in which you control your movement by moving your head and body. Tilt your head forward to move forward. I will be interested to see how well this works.
The bottom line of all this is that - our brains construct our experience of reality, and it is possible to hack that construction to fool the brain into believing that you are operating in a virtual reality. The experience, as primitive as it is, is already profound, and will only get more so.

Being involved in skeptical activism for over two decades does provide some perspective. One phenomenon I have noticed is that most pseudosciences and weird belief systems are, at their core, the same. Sure, the details vary, but the underlying errors in logic and thinking are the same. Essentially people make the same mistakes over and over again.
This, in fact, was the original motivation for developing a list of common logical fallacies. We kept encountering the same poor logic time and again and wanted to address the underlying cognitive errors. This is why scientific skepticism is so heavily involved with metacognition - thinking about thinking. There are thousands of fake medical claims out there, for example. Debunking every one is an endless game of whack-a-mole. Better to understand and address the underlying flaw in logic and method that leads to all the medical nonsense.
More recently this phenomenon has been dubbed, "Crank magnetism." This is the closely related notion that people who believe on type of pseudoscience tend to believe multiple types - they tend to attract each other. The cause of this seems obvious - if your method is flawed, you will achieve the same flawed results over and over.
There may also be different flavors of crank magnetism, although there is a lot of overlap also. For example, there are conspiracy theorists who believe every conspiracy, there are spiritual true-believers who are prone to believing anything mystical, and there are "nature is best" fanatics who are vulnerable to marketing anything as "natural" and fearmongering about "the chemikilz."
A new ballot initiative in California (of course) is an excellent representation of this latter flavor of sloppy thinking. It combines a reverence for anything natural, an irrational fear of chemicals, and anti-corporate conspiracy thinking into the mother of all crank-magnetism orgies. According to the state Attorney General:

REGULATES VARIOUS SUBSTANCES AND PRACTICES RELATED TO AGRICULTURE, CONSUMER PRODUCTS, AND HEALTH. INITIATIVE STATUTE. Prohibits genetically engineered plants and animals and over 300 listed substances from being used or released into the environment. Creates new state entity to regulate environmental activities, modify projects having pollution and radiation impacts, and test and approve substances before they can be introduced in California. Prohibits treatment of water with fluoride or chlorine. Regulates vaccine ingredients and eliminates vaccination as a prerequisite for attendance at schools and daycare facilities. Provides criminal and civil liability for violations, with no statute of limitations.

Basically this would put the inmates in charge of the asylum. The proponent of the measure, Cheriel Jensen, hopes to accomplish in one bill the wet dreams of anti-science activists over the last century. She has to collect the signatures of 365,880 registered voters (five percent of the total votes cast for Governor in the November 2014 general election) by August 6th in order to get on the ballot.
The most interesting aspect of the proposed bill is the blatant crank magnetism. It shows the overlap between the anti-vaccine movement, the anti-GMO movement, the anti-fluoridation movement, and the all-purpose toxin fearmongerers. They also throw in the more recent anti-smart meter conspiracy theorists. If it's new and technological, they are against it.
Obviously not everyone who is anti-GMO is also anti-vaccine. But there is a large overlap. In a recent survey of belief in medical conspiracies, 49% of those surveyed believed in at least one. Meanwhile 18% believed in three or more - it is that 18% that we are talking about here.
There are also cultural reasons for overlap, not just underlying philosophy or cognitive style. People who watch Dr. Oz or other TV doctors were more likely to accept multiple medical conspiracies. This is the "Goop" phenomenon - reverence for the vague concept of "natural," use of alternative treatments as empowering, and rejection of medical and scientific authority are now a "lifestyle."
Social media also reinforces crank magnetism. If you watch YouTube videos questioning the safety of vaccines, anti-GMO videos are likely to appear on the right of your screen. The echochamber reinforces the underlying philosophy, not just the specific belief.
This is the power of narrative that I have discussed often here. What psychological research (and personal experience) have revealed is that people need a way to make sense of a complex and often scary world. We need an explanatory narrative. Most of the time we accept the explanatory narratives that are offered up by our culture - we internalize them, embrace them, and then spread them.
One goal of metacognition is to think about these explanatory narratives. Why do we believe them in the first place, what are their strengths and weaknesses, are there any better approaches out there?
So essentially what we are seeing with this ballot initiative is a manifestation of a particular explanatory narrative, one that tries to make sense of the modern technological world as a conspiracy of powerful companies, powerful enough to control or at least heavily influence the government that should be regulating them, who are poisoning the public through careless use of toxins and chemicals. Meanwhile a plucky band of rebels seeks to expose the truth using social media. In this world view, kinder gentler powerful companies are selling the public natural products, food, and cures. Science and scientists cannot be trusted (unless they find what you want to believe and confirm your conspiracies). Anything "chemical" is suspect, and the slightest suggestion that a chemical is harmful can be taken as iron-clad.
Meanwhile, anyone who would challenge this narrative is a troll and a shill working for the powerful companies. You can just assume that to be true, without needing any actual evidence.
If that is your explanatory narrative, then that is the filter through which you see the world, and social media will conveniently cocoon you in an echochamber that reinforces the narrative. Within that world view, it makes sense that vaccines are poison, fluoridation is a conspiracy, GMOs are dangerous, and smart meters are spying on us. If you are willing to dismiss the scientific consensus on one, why not all of them? You have your "alternative" experts giving you alternative facts to support your alternative beliefs.
It will be interesting to see how the ballot initiative does. It is, in a way, a survey on how prevalent this narrative is in California. I suspect the initiative will fail, because it simply goes way too far, and only the 18% hard core believers will go for it. But we will see. Recently history has not been kind to my optimism.

A study from a few months ago is making the rounds due to recent write ups in the media, including Scientific American. The SA titles reads: "Cognitive Ability and Vulnerability to Fake News: Researchers identify a major risk factor for pernicious effects of misinformation."
The study itself is: _‘Fake news’: Incorrect, but hard to correct. The role of cognitive ability on the impact of false information on social impressions._ In the paper the authors conclude:

"The current study shows that the influence of incorrect information cannot simply be undone by pointing out that this information was incorrect, and that the nature of its lingering influence is dependent on an individual's level of cognitive ability."

So it is understandable that reporters took that away as the bottom line. In fact, in an interview for another news report on the finding one of the authors is quoted:

“Our study suggests that, for individuals with lower levels of cognitive ability, the influence of fake news cannot simply be undone by pointing out that this news was fake,” De keersmaecker said. “This finding leads to the question, can the impact of fake news can be undone at all, and what would be the best strategy?”

The problem is, I don't think this is what the study is saying at all. I think this is a great example of confusing statistically significant with clinically significant. It is another manifestation of over-reliance on p-values, and insufficient weight given to effect size.
Here's the study - the researchers gave subjects a description of a woman. In the control group they asked them to rate her probable qualities, how much they liked her, how trustworthy she was, etc. In the intervention group they also gave the subject false information about her, that she sold drugs and shoplifted in order to support her shopping habit. They also gave a cognitive ability test to all subjects, and divided them into high cognitive ability (one standard deviation above average) and low cognitive ability) one standard deviation below average).
Above is the graph of the results (high definition version here). As you can see, in the control group both high and low cognitive subjects rated the fictitious person as an 82/100 in quality. The intervention group, after give the false negative information, rated her much lower, a 24/26 in the low/high cognitive ability groups respectively. Then, the false negative information was corrected - the subjects were told, never mind, this false information is not true. Now how would you rate the person? The high cognitive ability group then rated her as an 85, while the low cognitive ability group rated her as a 78. The difference between the 85 and the 78 was statistically significant.
I look at this data and what I see is that in both cognitive ability groups, the false information had about the same negative effect, and the correction had about the same corrective effect, and in fact essentially completely erased the effect of the false information. I am not impressed by a tiny but statistically significant effect.
The small effect size has two major implications. The first is that it calls into question the reality of the effect at all. Essentially, the study has a small signal to noise ratio, and this is problematic, especially when dealing with human subjects. It's just too easy to miss confounding factors, or to inadvertently p-hack your way to a significant result. That probably has something to do with the replication problem in psychological research.
But even if you think the study is rock-solid (and I don't), and the results are entirely reliable, the effect size is still really small. I don't know how you can look at this data and conclude that the bottom line message is that people with lower cognitive ability (as defined in this study in a very limited way, but that's another issue) had difficulty correcting false information. They corrected from a rating of 24 up to 78, with a control group rating of 82. Are you really making a big deal out of the difference between 78 and 82? Is that even detectable in the real world? What does it mean if you think someone's personal qualities rank 78/100 vs 82/100?
With any kind of subjective evaluation like this, how much of a difference is detectable or meaningful is a very important consideration. I would bet that a difference between 78 and 82 has absolutely no practical implication at all. That means that effectively, even the people in the lower cognitive group, for all practical purposes, corrected the effect of the false information.
I am also not impressed by the difference between the low and high cognitive groups - 78 to 85. That is still not a difference with any likely practical difference. Even this small effect size may be an artifact of the fact that the high cognitive group over-corrected (compared to controls) by a small amount (also insignificant).
And yet the Scientific American headline writer wrote that with this research, "Researchers identify a major risk factor for pernicious effects of misinformation." "Major" risk factor? I don't think so. Minor and dubious is more like it. What this research does show is that subjects easily and almost completely corrected for misinformation when pointed out to them.
But even that conclusion is questionable from this data, because the research conditions were so artificial, and the researchers characterize them as ideal. The false information was quickly and unequivocally reversed. This is not always the case in the real world.
Unfortunately I see this phenomenon a lot. Social psychology studies take a tiny but statistically significant outcome, and then over-interpret the results as if it is a large and important factor. Then journalists report the tiny effect as if it is the bottom line result, leaving the public with a false impression, often the opposite of what the study actually shows.
We see this in medicine all the time also. This is the frequentist fallacy - if you can get that p-value down to 0.05, then the effect is both real and important. However, often times a statistically significant result is clinically insignificant. Further, small effect sizes are much more likely to be spurious - an illusion of noisy data or less than pristinely rigorous research methods.
This is why some journals are shifting their emphasis from p-values to other measures of outcome, like effect sizes. You have to look at the data thoroughly, not just the statistical significance.
Further, researchers have to be careful not to oversell their results, and science journalists need to put research results into a proper context.

Here we go again.
If you are in a decision-making position at an institution of higher learning than you have a responsibility to understand and protect the academic reputation of that institution. Further, such institutions (many of which, as in this case, are publicly funded) have a responsibility to society, to promote academic standards and legitimacy. At the very least such institutions should not be promoting pseudoscience, or dressing up any nonsense as if it were real.
Georgian College in Ontario has approved funds and plans to open a program that will teach homeopathy as if it is real medicine. Teaching any pseudoscience is an outrage, but when it is medical pseudoscience there is also arguably another layer of malfeasance because the connection to real harm is more direct.
I know this is old territory here, but for review: Homeopathy is a prescientific philosophy-based system based on magical thinking. Its core ideas were never valid, and have never been supported by science. Essentially, homeopathy uses fanciful treatments that are based on silly ideas, such as the personality of the patient, but also "sympathetic magic." The belief is that homeopathic remedies contain the magical essence of symptoms and can be used to cure those same symptoms.
Then, doubling down on the idea of magical essence, all actual substances are diluted out of existence, so that only the essence remains. Therefore, in reality, only water remains. Homeopathy is literally treating people with magic water created with rituals resembling witchcraft, and without the tiniest bit of scientific legitimacy.
Despite this, a great deal of resources have been wasted studying whether such magic potions work or not. Unsurprisingly, the totality of this research shows that homeopathy does not work.
Homeopathy proponents, however, will not acknowledge this reality. They cherry pick, distort, lie, ignore, and engage in an impressive array of motivated reasoning to maintain their belief in magical potions. I have no idea where any individual homeopathy seller is on the spectrum from con-artist to true-believer, but it doesn't really matter. They represent some combination of not caring about scientific evidence, or not being able to understand the evidence.
There is no real controversy here. This is the clear scientific consensus, and is unambiguously supported by the science.
So, how could an academic institution consider teaching a degree program in pure nonsense? That's a good question. Let's here from Fay Lim-Lambie, dean of health, wellness and science at Georgian College.

“As an educational institution we welcome critical discussion and debate,” she said. “It helps ensure the best possible curriculum and learning outcomes for our students.”
She added that, “In an era of patient choice, it is important for the college to provide students with the most diverse education possible, including options for care and different methods.”

I'm sorry, the dean of what? Was that health and science? I hear there is returning interest in astrology. Perhaps the astronomy department (if they have one) should consider teaching astrology in order to cater to this interest, to give their students a diverse education. Let's have a critical discussion and debate about that. Seriously - if you think a program in homeopathy is appropriate at your institution, then you have absolutely no basis on which to deny programs in cryptozoology, creationism, crystal healing, UFOlogy, or free energy. You have abandoned all pretense to academic standards.
This is a transparent populist appeal which is anti-intellectual and pseudoscientific. This is, and should be, an embarrassment to Georgian College, Ontario, and to academia in general. The only appropriate response is outrage and condemnation.
There is nothing to debate, Lim-Lambie. Homeopathy is utter nonsense from beginning to end. If you don't understand that thoroughly, you have no business being a dean of either health, wellness, or science. And why wasn't this desired debate happening before the funds were approved for this dubious program? Does she only want to have a "debate" now that there is public awareness of what is happening with the resultant appropriate criticism and pushback?
Yes, I am being hyperbolic in this article, deliberately. The point is that legitimizing pseudoscience in the health department of a university is extremely harmful. It promotes pseudoscience, it legitimizes nonsense, and it undermines any attempt at academic quality control.
It furthers the watering down of reality in our society by promoting a false equivalency among all claims. Everyone gets to have their own reality, their own narrative, their own facts and evidence. If there is no difference between academic legitimacy and the worst kind of medical magic thinking, then we truly do live in a post-fact world.
I know that most of us have already spent our budget of outrage, but we cannot become inured to this loss of standards, to the infiltration of witchcraft into medicine. I am not a fan of public shaming, but sometimes that is the only way to maintain norms and standards. Georgian College and Lim-Lambie should be ashamed. They have failed their primary duty as academics.
But I also believe in nurturing and redemption. Let's use this opportunity to have a public and transparent discussion of exactly what homeopathy is, and what the evidence says. Homeopathy proponents like flying under the radar, and the public largely does not understand what homeopathy actually is. So let's put it out there. If Lim-Lambie wants to defend homeopathy "science" then she should do it - publicly. Please, proceed.
Update: In response to intense criticism, Georgian College has removed their homeopathy program.
http://www.cbc.ca/news/health/georgian-college-diploma-homeopathy-pseudoscience-1.4529339

Between 12,800 to 11,500 bp (before present) there was a cold period in North America called the Younger Dryas - named after the dryas flower whose pollen is a good marker for such cold periods. During this time the megafauna of North America, including the Mammoth, largely died out. Along with them went the Clovis culture - a big game hunting culture with distinctive stone points.
What caused this period of climate change and mass extinction?
This is a genuine scientific controversy. One group of scientists believe that the melting glaciers dumped fresh water into the northern Atlantic, temporarily shutting down the ocean currents that bring warm water to North America. Another group think that a comet impact is to blame.
There is no smoking gun of a comet or meteor impact at this time, however. This is partly why the debate continues. However, there is significant inferential evidence, and as this evidence grows we may be getting to a tipping point where the comet theory becomes dominant.
There are two new published papers which the authors claim support the comet theory. I don't know if this will be the tipping point, but the evidence is starting to seem pretty compelling. We'll have to see how the other side reacts.
THE BIG BURN
So far the evidence presented for a comet impact is indirect but some scientists find it compelling. Mostly it consists of finding exotic materials in the geological layer that corresponds to the Younger Dryas boundary.
These exotic materials include spherules, nanodiamonds, melt glass, and a platinum spike. Comet impact proponents argue that these materials resulted from the impact. Critics claim that they are either erroneous or result from other causes, such as forest fires. And in any case - without an impact crater, the case for an impact is thin. Meanwhile the case for glacier melt is strong.
Now the comet proponents are firing another salvo - evidence from ice cores and other studies showing that right at the Younger Dryas boundary layer there is evidence for massive biomass burning. Further, there is a CO2 spike at the same time, enough to suggest that as much as 10% of the plant life on Earth at the time burned.
What this could mean is that there wasn't a single impact, but that essentially the Earth passed through the cloud of a comet and was hit by a swarm of smaller pieces, igniting forest fires around the world. Smoke from these fires could have then resulted in an impact winter - blocking out the sun reducing photosynthesis and reducing temperatures.
This conveniently explains away the absence of a large impact crater, while also explaining the presence of exotic impact-related materials, and also the products of massing burning, all at the Younger Dryas boundary layer.
This sounds like a reasonable case for the comet theory. Will it be compelling enough, however, to win over former critics?
SCIENTIFIC CONTROVERSIES
That is often how these scientific controversies work. Different factions make their case in the absence of definitive evidence, and also point to future evidence that will support or refute their hypothesis. The various sides duke it out, until eventually the evidence builds enough on one side that the majority of scientists come over.
There is no magic threshold, but at some fuzzy point we may have a consensus built on evidence that has been thoroughly debates by proponents of various hypotheses. A consensus does not mean 100%, no further evidence needed, the science is over. It just means that the evidence is strong enough in support of one side that the vast majority of scientists now accept that as the most likely answer.
There is always room for minority opinions, and sometimes surprising lines of evidence may disrupt the debate.
We see this process with many current scientific controversies. Is floresiensis (the Hobbit) a unique species or a diseased human? Did the dinosaur extinction result entirely from an impact, or did other sources of climate change play a role?
For a time there was serious debate about whether or not dark matter existed or were observations explainable by modifying Newtownian gravity. We have now reached a consensus that some form of dark matter probably exists - but until we identify exactly what it is, there is room for dissent.
There are countless such debates, big and small, in the world of science. That is how science works and progresses. For every question, there is a spectrum from unknown, to genuine controversy, to strong consensus, to rock solid. Science communicators should always strive to put any new study or bit of evidence into the context of where the scientific question is on this spectrum.
Further, there are practical implications for properly characterizing the state of a scientific controversy. What do we teach in classrooms? What research do we fund? Was medical treatments are acceptable, and should be reimburse with public funds? And what scientific conclusions are sufficient to base public policy on?
There is no formula. This takes judgment, a thorough understanding of the science, and an individual decision. Conclusions also have to remain open to revision as new evidence and theories come to light, but we also have to make decisions in the meantime.
The obvious controversy to which all this applies is global warming, because it is such a hot political topic. The prevailing scientific opinion is that there is a strong-enough consensus that global warming is happening and is due to human activity to form a basis for policy. That does not mean the science is over, and there are always error bars on every scientific conclusion. But we have a practical consensus. It would be folly to ignore it, or to focus myopically on uncertainty in order to manufacture paralysis.
It is useful to examine non-political scientific debates and controversies, to see how they work, and how they are resolved. Not many people are going to have a strong ideological position on the Younger Dryas, and I don't expect to see it in the platforms of major political parties. That is why it is a great way to see how science works. Those lessons can then be applied to more politically controversial topics.

A recent systematic review and meta-analysis of the effects of mindfulness meditation on prosocial behavior found, essentially, that there is no evidence that it works. I find these results entirely unsurprising, and they yet again highlight the need for rigorous research before concluding that a phenomenon is real.
As I discussed recently on SBM, mindfulness meditation is the practice of sitting quietly, focusing inward and on the present, and avoiding mind wandering or daydreaming. The recent review I discussed on SBM found that the research into mindfulness, however, does not use a uniform or operationalized definition. That is critical to good science - you need to carefully define something before you can do research on it.
It is especially important to specifically define a concept in order to do research into the question of whether or not the phenomenon is real. If your question is, "Does X exist," you better have a very specific definition of what X is. Otherwise it is easy to misinterpret the evidence, or to wiggle out of evidence that X does not exist.
The best example of this in medicine is acupuncture. Acupuncture is defined as sticking thin needles into acupuncture points - except when research shows that it does not matter where or even if you stick the needles, then acupuncture can be something else, which is vaguely defined.
Once you have a specific definition, with clearly identified variables, then you can study if those variables which constitute the phenomenon in question have a specific effect. For mindfulness - what is the effect of relaxation, introspection, or avoiding daydreaming? Does mindfulness differ from other methods of achieving these same effects? Perhaps mindfulness is nothing more than relaxation, or perhaps any perceived effect comes from being distracted for a time from the stresses of your life.
In other words, mindfulness may not be a real distinct thing, but just one method of achieving other more fundamental states, such as relaxation. This is what appears to be the case, based on years of research, in which case proponents should claim, "Mindfulness is an effective method of relaxation, which can have benefits," not "Mindfulness is a unique phenomenon with specific and unique benefits."
Does this matter? Absolutely. It is almost guaranteed that when I post an article such as this someone will say, "Who cares, as long as it works." But this is an unscientific attitude. In science, the details do matter. We need to know what is really real, because it affects how we implement interventions and how further scientific research proceeds.
Using acupuncture as an example again - if the sticking of the needles adds no specific effect or value, and all the benefit derives from the interaction with the acupuncturists (which is what the research clearly shows), then we can dispense with the needles. The needles are invasive and come with risk. Further, we don't need to speculate about the mechanism of benefit from sticking people with needles, because there is no mechanism. We can shift our focus to the real phenomenon - a subjective effect from a positive therapeutic interaction.
With mindfulness, because there is nothing invasive, the situation is the same, if less obvious. If, as the recent review shows, watching nature documentaries are as effective as mindfulness, then you can simply turn on the TV, learn something about nature, and get all the apparent benefit of meditation. You also don't have to spend hundreds of dollars on that mindfulness course. We can further stop wasting our time researching a scientific dead end.
Let's get back to the recent review to see those details. What the researchers found when they reviewed the literature on prosocial behavior is that the research did not establish that mindfulness had any specific benefit. First, we need to define prosocial behavior more specifically. The authors write:

Five types of social behaviours were identified: compassion, empathy, aggression, connectedness and prejudice. Although we found a moderate increase in prosociality following meditation, further analysis indicated that this effect was qualified by two factors: type of prosociality and methodological quality. Meditation interventions had an effect on compassion and empathy, but not on aggression, connectedness or prejudice.

That's important to know for research, but not really the most interesting finding of the research. They also found:

We further found that compassion levels only increased under two conditions: when the teacher in the meditation intervention was a co-author in the published study; and when the study employed a passive (waiting list) control group but not an active one.

So studies were only moderately positive when one of the study authors were teaching the subjects meditation. This suggests that researcher bias is at work.
Perhaps more importantly, however, is the fact that there was only a measured effect when there was a waiting list control, meaning there is an unblinded comparison where the subjects had no intervention. When the control was "active", meaning the control group had some intervention, then there was no effect. This intervention could simply be watching a nature documentary. This one fact alone means the research is negative. Everything else is interesting, but doesn't really matter.
The meta-lesson here is that this kind of analysis of the entire literature on a specific scientific question is necessary before you can come to any reliable conclusion about efficacy. If you want to know if an alleged phenomenon is real, you need rigorous research in which variables are clearly defined and adequately controlled for. Further, you need positive results with a clinically significant (adequate signal to noise ratio), statistically significant, and independently replicated effect. Until you get to that threshold, you are likely just dealing with researcher bias, p-hacking, publication bias, and loose methodology creating the illusion of a positive effect.
With some alleged phenomena, however, we never get to the threshold of acceptance. The research just goes around in circles chasing its tale. This is true of acupuncture research, mindfulness meditation, ESP, homeopathy, and essentially all the familiar pseudosciences. All we get are excuses, hyping of preliminary research, cherry picking positive studies, and personal attacks against skeptics who would dare to question the alleged phenomenon. In medicine we also get the, "Who cares, as long as it works." This, of course, misses the point that the alleged treatment doesn't really work, it is all an illusion.
Another defensive response is to claim, "Well, that is not the real claims being made for X. It's really about this other thing over here." This kind of response, however, is usually just part of a dance of avoidance. "They didn't study real astrology." "That is not the real reason to fear GMOs."
But this approach, which often is just motivated reasoning, further misses the point that the person making the claim has the burden of proof. It's not on me to prove with high quality research that mindfulness doesn't work for every possible claim made for it. Proponents have to adequately demonstrate that it does work for a specific claim, and they haven't. Scientists will then conclude, "The research does not justify rejecting the null hypothesis." This is technically true, as is appropriate in scientific discourse. When communicating to the public, however, it makes it seem like we don't really know the answer.
At some point (and where this point is admittedly requires judgement, which includes an evaluation of plausibility) a lack of evidence can be treated as, "OK, this probably doesn't work." At the very least, we can conclude that this is a scientific dead end.
There is also an asymmetry in the media. A systematic review like this, concluding that the evidence is inadequate to support a conclusion that mindfulness is effective in promoting prosocial behavior, just doesn't get that much play. However, a crappy preliminary study with poor methodology and brimming with bias and p-hacking, which shows an apparent tiny effect, will be promoted in the media as proving that mindfulness works magic. Rarely will such studies be put into the context of the entire literature.
Media and marketing forces tend to lead to an adoption of new ideas long before they are adequately demonstrated. Then once they are embedded in the culture and the popular consciousness, they are hard to eradicate. The public ends up believing a lot of stuff that is simply not true. Then when skeptics or scientists point out that the research was never adequate to conclude the phenomenon is real, and now after 20 years or so we can more clearly say it probably isn't, they seem out of touch. Everyone already knows that antioxidants are great for you, never mind that the research shows they have no benefit.
We can now probably add mindfulness to the list. I was never impressed with the research, and the claims always seemed poorly defined. Now, we have multiple systematic reviews which show essentially that. We may not be at the point where the concept can be completely abandoned, but we are at least getting close. The most parsimonious interpretation of the science at this point is that mindfulness is just a ritualized form of relaxation, with no specific benefit beyond that. If you enjoy it and find it useful, fine. If you prefer watching Blue Earth II, then I'm with you. Just don't spend hundreds of dollars on courses, tapes, or seminars because you bought the hype.

On the Canadian Entrepreneur show, Dragon's Den, the dragons were given a demonstration of a clip (that's right, a small metal clip like you would use to hold papers together or put in your hair) that the creator claimed would improve your balance, strength, and health through the power of "quantum entanglement." The clips, called Neuro Connect, were "developed" by a chiropractor and his partner. The Dragons fell for it, amazed by the demonstrations, and invested $100,000 for a 30% share.
The show aired, giving a huge boost to the company's sales. However, the way the show works, even when the Dragons make a deal on camera, the deal is contingent on them doing due diligence for confirmation. When they did they found that there were serious scientific objections to the claims being made by company selling the clips, NeuroReset Inc. The deal was off.
But this did not stop the show from airing. The public did not get the benefit of their due diligence - they protected themselves, but completely threw their audience under the snake oil bus. Canadian news outlet CBC contacted the producer to get their response:

Executive producer Tracie Tighe was asked what responsibility the show has to protect consumers from products that make false or outlandish claims.
"The entertainment value of this first meeting is what appeals to our viewers and is the pillar of success for this reality format," she said in an email. "The pitchers sign extensive releases/agreements and they are required to confirm their business proposals comply with all applicable legislation."

Typical - in other words, we don't care if we are deceiving our audience. We hold ourselves to no responsibility. We will air the Dragons fawning over a product we now know is bogus and where they backed out of the deal without giving our audience this information, because it is entertaining (i.e, it makes us money). So the producers of Dragon's Den are snake oil salesman also.
The Neuro Connect clip itself is just a recycled scam. This is the Q-bracelet, the power band, the Goop stickers all over again. The formula is now well established. Take any small cheap piece of plastic, rubber, or metal. Give it an exotic name or one that implies a claim or a mechanism. Then claim that by wearing the doodad you will have more energy, better balance, improved strength, or that great catch-all term, "wellness."
How does this miracle little thingamabob work? Science, or something. Energy, bla bla, vibrations, bla bla, magnetic quantum phase inverters bullshit, bla bla.
That is really it. Anyone can be the next energy doodad entrepreneur. Just find a factory in China that can make small plastic widgets really cheap and print your custom log on it, and that make up some formulaic BS about energy, and that is apparently enough to fool (at least for a while) allegedly expert investors.
To really sell it all you need is knowledge of a few simple parlor tricks. Here is NeuroReset demonstrating the parlor trick to sell their snake oil. Here is Richard Saunders in 2012 exposing the same exact parlor trick.
There are a few similar parlor tricks that have done a lot of heavy lifting helping snake oil salesman make their sale. The one in the videos is an old "applied kinesiology" trick that has been used in many contexts. You have the mark hold up their arms to the side. Then you push on the arm so show how weak they are. Give them the quantum entanglement whatever, and then when you push they are stronger - you can't break them. However, small changes in where and how you push make all the difference.
There are other tricks where you have people rotate to see how flexible they are - they always rotate a bit further on the second try, and when they have a target to beat (when they are using the magical device).
And of course this is a great example of using the latest scientific knowledge to dazzle a scientifically illiterate audience. There is simply no way that a Canadian chiropractor has unlocked the potential of quantum entanglement. It's a fair bet he does not even understand what quantum entanglement really is, or how we experimentally know it exists. He has no explanation for what is actually happening, or how he managed to exploit quantum entanglement in a little metal clip (I'm sure the physicists of the world are fascinated).
And when confronted with this he gives the same answer that most snake oil peddlers give:

"Can you criticize me for no peer reviewed studies? Absolutely," he said. "We're helping too many people, which is why I'm standing up for it."

That right - I am too busy curing people to bother with conducting rigorous studies. This is a giant red flag for a scam.
Regulatory agencies are trying to do their job:

In an email, Health Canada said it's investigating potential additional claims for two other Neuro Connect products. The agency said appropriate action will be taken if it finds compliance issues.

Sure, but this is just a game of whack-a-mole. There is an asymmetry here in which it is far too easy to mass produce these snake oil scams, which then takes far too much time and resources for a government agency to investigate. By the time they do, the company has made their money and moved onto the next scam.

Hopefully it's not news to you that the Earth is warming due to human release of carbon dioxide and other greenhouse gases. A number of studies have assessed the scientific consensus on anthropogenic global warming (AGW), with results clustering around 97%. Overwhelmingly, most climate scientists have looked at the data and concluded that AGW is happening.
Climate scientists have gone beyond just establishing that AGW is happening. They are trying to quantify it and project the trend lines into the future. This type of effort is always fraught with uncertainty, with the error bars increasing with greater time into the future. However, we can take a 95% confidence interval and make reasonable extrapolations of what is likely to happen.
Recognizing this uncertainty, the Intergovernmental Panel on Climate Change (IPCC) has concluded that we should keep post-industrial warming to less than two degrees Celcius if we want to avoid serious effects of climate change. Given that as the goal, they can then determine how much more carbon would need to be released to cause this amount of warming. This can be used to determine how much we need to decrease future carbon emissions.
Primarily those with an ideological or financial stake in denying this solid consensus focus on the uncertainty. But that is folly. Phil Plait has a good analogy - if 97% of the world's astronomers were in agreement that there was a 95% chance of an asteroid hitting the Earth in 2050, would you be listening to the 3% of dissenters? If NASA and other experts were mostly saying that it will take 20 years to develop the technology to deflect the asteroid, and the earlier we do it the more effective our attempts will be, do you think it would be prudent to argue for waiting a couple of decades to see what happens? Maybe the asteroid is not as big as they say. Maybe it will hit in a remote area and not do that much damage. It may cost less to fix the damage than divert the asteroid. Asteroids deliver useful metals to the Earth's surface, so this could be a good thing. Don't listen to the asteroid hysterics. The motivated reasoning is transparent.
Denial aside, we are now getting to the point that simple math is constraining our options. We have to reduce our carbon release quickly in order to avoid the 2 degree C warming. We can argue about how quickly, but we are actually just arguing about how long it will take for the worst outcomes to be manifest. It is not a question of if, but of when. We can hope for the best outcome, but should plan on the 95% confidence interval.
Those same scientists, however, are saying essentially that it is highly unlikely we will be able to reduce CO2 emissions quickly enough. We will certainly not do it if current trends continue - the math just does not work. Still we need to do everything we can - increase energy efficiency, shift to renewable energy, and reduce fossil fuel use.
Another option is carbon capture - remove carbon from the atmosphere to offset the new carbon being released. Here the IPCC has a dilemma. They have charted all possible pathways to avoid the 2 degrees warming, and they have concluded that essentially we cannot do it through reduction of emissions alone. In the second half of the 21st century we will need to remove a significant amount of carbon from the atmosphere, about 12 billion tons per year, or a third of the current rate of release.
However by focusing on carbon capture they worry that people will see such technologies as the ultimate solution, and therefore we don't have to worry about reducing carbon release. So now they are also emphasizing that carbon capture will not be enough. We need to do both - reduce emissions and carbon capture.
This is where another layer of thinking comes in - techno-optimism. There are those who argue that we will technology our way out of this dilemma. Renewable energy technology will advance and replace dirty old energy technology. We will also develop high-tech carbon capture technology and take care of all that extra carbon. I am sympathetic toward this attitude, but I also agree that we cannot rely on technological advances we haven't made yet. These are always hard to predict. Again - hope for the best, but prepare for the worst. We can't just assume that in 30 years we will develop a technology to deflect the asteroid.
But what is the state of carbon capture? One approach is essentially to use plants, specifically trees. Trees are natural carbon capture devices. There are already efforts at reforestation, and to reduce deforestation, and they should continue. But this will not really address the problem. There isn't enough land to simply plant trees to capture carbon, and trying to use lots of land for this approach will likely be counterproductive.
There is one company, Climeworks, that uses artificial filters to capture carbon. They have one factory that currently captures 1000 tons of carbon per year. If you remember from above, we would need about 12 million of these to reach our goal. That is why the IPCC is now saying we cannot rely on this technology alone. How much space would all that carbon capture require?

The company calculated how many shipping container-sized units would be needed to capture 1% of global emissions; the answer was 750,000.

So again, multiply that by about 30 for what we would need.
The technology works by using fans to blow air over filters which capture carbon dioxide. When the filters are full they can be heated to release the carbon in solid form. That solid carbon can be buried or used for industrial use - you can combine it with hydrogen to make plastics or fuel, for example.
It seems that some such technology will be necessary to reach our goal of limiting warming to 2 degrees C. This technology at least works, but it is primitive. It seems prudent to encourage development of this technology. One way to do that is to put a price on carbon. I agree with those who argue that this makes sense and is fair, since releasing carbon has a cost to the world, those who release the carbon should share in that cost. They could, however, offset that cost by also building carbon capture facilities, or buying carbon credits from those who do.
Make a carbon capture industry cost effective, and it is likely the technology will advance and be adopted. Then we might technology our way out of this.
While I remain hopeful, maybe even optimistic, I realize that the math currently looks bad. We cannot get complacent. Now really is the time to shift to renewable energy, to focus on energy efficiency, and to put a proper and fair price on carbon to encourage a carbon capture industry. This is a win win - we will end up with a better energy infrastructure, and a better environment.

The New Yorker magazine's latest issue features an article about the sad story of Jahi McMath. Jahi was a 13 year old girl who four years ago underwent a routine tonsillectomy to treat severe snoring and breathing problems. Unfortunately the surgery was complicated by severe bleeding post-op, leading eventually to a cardiac arrest. After a sustained effort at resuscitation the doctors did manage to get her heart working, but by that time her brain was severely damaged by lack of oxygen. She was declared clinically brain dead.
This is not where the story ends, however. Since then the family has refused to accept the diagnosis of brain death, prompting a prolonged conflict with the hospital. Eventually Jahi was removed by the family to an undisclosed hospital in New Jersey, and ultimately discharged to home care, where she remains.
I have had several questions about the story, and I will try to add some insight, with the caveat that I have no direct knowledge of the medical facts of the case beyond what is reported in the New Yorker article and elsewhere. I have not examined her, spoken directly to anyone involved in her care, or reviewed medical records. But there is a lot of information in the public domain and I can speak to that information, as far as it is accurate.
There are several layers to this story. There is a legal layer, as the family is suing the hospital for malpractice. I will not address that aspect of the case. There is the neurological layer - what is brain death and is this girl dead? There is also a personal and cultural layer here in terms of the family's reaction. Let me start with some thoughts on this.
I will first say that I completely sympathize with the family. Of course it is horrible and tragic to lose a healthy 13 year-old child to a routine surgical procedure gone horribly wrong. I understand their anger, frustration, and grief. In addition, the family (again, according to public reporting) has lost trust in the hospital and in the system. They are African American and feel that there is an aspect of discrimination in how Jahi was treated. The mother, Nailah, is quoted in the New Yorker article:

Nailah, who worked in contractor sales at Home Depot, said, “No one was listening to us, and I can’t prove it, but I really feel in my heart: if Jahi was a little white girl, I feel we would have gotten a little more help and attention.”

This is an extra layer of tragedy in the case - the family was meant to feel as if an element of racism played a part in Jahi's outcome. I have encountered this myself numerous times, sometimes with some legitimacy, but often (from my perspective) when no racism was present. I can't speak to the state of mind of any of the caregivers in Jahi's case. But the reality is that her family lived with enough racism in society that it affected their ability to trust the system.
Allowing your child to go under the knife requires a tremendous amount of trust. Further, medical care can often feel impersonal, and can be intimidating when scary things are happening that you do not fully understand because you are not an expert yourself. When that trust, and that feeling of lack of control, is paired with a horrible outcome, it is natural to feel betrayed.
Those feelings, in the context of a minority family, appears to be driving this case to a significant degree. Now those same doctors are telling the family that Jahi, who looks alive, is actually dead. They don't want to let Jahi down again by trusting those same doctors.
Unfortunately, when there is a critical break down of trust like this in a complex case, we don't really have a good mechanism for resolving any conflict. Doctors and hospitals usually defer to the family as much as possible, giving them time to process their grief, having family meetings, calling in other experts to weigh in, etc. None of this was enough, however. It also seems that the family has dug in their heels, and may now be too invested in their belief that Jahi is alive to let her go.
This leads us back to the neurological layer of this story. The New Yorker article framed their piece as a question - what is the definition of life. There is a legitimate question in there, but I don't think it is actually that controversial outside of certain religious sects.
Obviously, when someone stops breathing and their heart irreversibly stops beating they can be declared dead. For a time, however, the cells in their body are not dead. There is a window when someone may be dead, but it is not necessarily impossible to resuscitate them. Doctors use their judgement when deciding to stop attempts at resuscitation. Part of that judgement is how much brain damage may have resulted from the prolonged arrest. There is no point in getting a heart beating again if the brain is dead or almost dead.
For this reason the medical and legal concept of brain death was developed. You can also declare someone dead even if their heart is beating if a thorough examination clearly indicates that there is zero brain function. Not only the higher parts of the brain, but the brain stem and the brain reflexes must also have no function. You can still have spinal cord reflexes, however, and still be considered brain dead. You can also demonstrate the complete absence of brain wave activity, or the complete absence of blood flow to the brain.
In Jahi's case, a neurological exam specifically designed to test for any flicker of brain activity was consistent with brain death. Further, a blood flow scan showed no blood flow to the brain. She was declared brain dead, and is legally a corpse (to be blunt). That is why the family moved her to New Jersey, which is one of only two states that recognize religious objections to the notion of brain death.
This is where we now get some complexity, although I honestly don't think it changes the situation. Dr. Alan Shewmon got involved with the case - he is a neurologist who objects of ideological and religious grounds to the notion of brain death. He reviewed video of Jahi and concluded there is evidence in the video of brain activity, therefore she is not dead.
Essentially, Jahi occasionally twitches her fingers or toes. These are almost certainly spinal reflexes, and not inconsistent with brain death. Nailah, her mother, believes that Jahi is responding to verbal commands. She will tell her to move a finger, and then sometime later Jahi will move a finger. If it's not the right finger Nailah will say, "Not that one" until she twitches the correct finger.
This is also very common - family members tend to overinterpret random movements as if they are deliberate. Shewmon believes that the movements are more accurate than can be explained by random chance, but I am doubtful. Further, he may not be accounting for selection bias in the videos he is being shown.
There is good reason to believe that Jahi simply cannot be following verbal commands. The New Yorker reports:

On the scans, Machado observed that Jahi’s brain stem was nearly destroyed. The nerve fibres that connect the brain’s right and left hemispheres were barely recognizable. But large areas of her cerebrum, which mediates consciousness, language, and voluntary movements, were structurally intact.

There are two things to note here. This study apparently does show some remnant of brain tissue. If there were zero blood flow the brain would be entirely gone by now. So there is likely a small amount of residual blood flow, too little to show up on the prior scan, that is keeping some brain tissue alive. However, that does not mean that this remnant is functioning at all.
But perhaps more important is the fact that the brain stem is "nearly destroyed." The brain stem is necessary for a person to be conscious. Even if your entire cortex were intact and unharmed, without a brain stem you would be in a permanent coma, without the ability to generate wakeful consciousness.
Further, without a brain stem there is no way for auditory signals to get to the brain. Jahi cannot hear, and therefore cannot respond to verbal commands. Therefore the video evidence of her finger twitching is not evidence of consciousness.
There is perhaps a legitimate discussion to be had about whether or not the remnants of brain tissue mean Jahi is truly completely brain dead or not. But in my opinion, this is a distinction without a difference. She is clinically brain dead, and any remnant is irrelevant. She is not aware of her own existence. Without a brain stem she cannot be conscious. It is sad to say, but there is no functional difference from Jahi's perspective between being fully dead and whatever flicker of brain activity may plausibly remain. It is effectively nothing.
The family may be beyond the trust necessary to accept this reality. They also appear to be enabled in their denial by Shewmon, who has an agenda of his own.
Meanwhile millions of health care dollars have been spent maintaining this poor dead girl's body, with no end in sight. The family remains in a limbo of denial. The other child in the family must live in the shadow of their dead sister, who absorbs much of the family's time and resources. Legal expenses are also piling up. The entire saga furthers a narrative of distrust. It is a tragedy from beginning to end.